WHO Group Says Evidence Favors Most Forms of Colorectal Cancer Screening

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The World Health Organization's International Agency for Research on Cancer (IARC) concludes that stool-based tests and lower endoscopy reduce mortality from colorectal cancer. Their work in the New England Journal of Medicine coincides with the Saudi-International Colorectal Diseases Forum.

The group found that there was sufficient evidence for a reduction in mortality from screening every 2 years with guaiac test without rehydration, every 1–2 years with higher-sensitivity guaiac test with rehydration, and every 2 years with fecal immunochemical test (FIT), as well as single screenings with sigmoidoscopy or colonoscopy. There was limited evidence for computed tomography colonography.

In terms of reducing cancer incidence, guaiac testing without rehydration didn't seem to have an effect; there was limited evidence for higher-sensitivity guaiac testing, FIT, or CT colonography; and there was sufficient evidence showing a benefit with sigmoidoscopy and colonoscopy.

There was not enough evidence to compare screening methods with one another.